How effective is the quality assurance as a result of external checking of nursing homes by the public health services

This is a report on the external checking of nursing homes by the Public Health Services in Duisburg, Germany, focussing on hygienic problems. For a second time in the last three-and-a-half years a total of 41 such homes were inspected and a total of 4150 residents were covered. Data on the intensity of care and on the hygienic standards were evaluated and compared with the results of 1998. 70.73 % of the homes inspected employed a nurse specifically trained in hygiene-management (1998 15 %), 53.66 % used disinfectant textile cleaning and 34.39% possessed written standards for management of infections relevant for nursing homes. 1.45 % of all residents had pressure sores III degrees and IV degrees classified according to Shea (1998: 3.37%). In spite of significant improvements, deficits were still registered. To achieve further improvement attention should be focussed on the effectiveness of Public Health Services' activities. Increased co-operation with other institutions engaged in the external checkings as well as a closer focus on specific subjects in hygiene could be appropriate.